Carbohydrate counting in the management of diabetes.
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PURPOSE: People with type 1 diabetes who follow an intensive management program have an increased risk of hypoglycemia, particularly overnight. New strategies for the nutritional management of hypoglycemia are essential. METHODS: The unique properties of foods that affect blood glucose are reviewed, with special attention to a new medical food bar designed to reduce the incidence of nocturnal hypoglycemia. RESULTS: All carbohydrate-containing foods affect blood glucose, but each causes a different rise in concentration. Consuming a variety of conventional foods with different glycemic indices can help control hypoglycemia. A new medical food bar that provides a sequential triphasic release of glucose from sucrose, protein, and uncooked cornstarch can help control blood glucose levels. CONCLUSIONS: Hypoglycemia can be avoided by consuming foods with varying glycemic indices. A new medical food bar that provides sequential release of glucose into the bloodstream may also help control blood glucose levels.
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The computer-assisted menu design still remains a difficult task. Usually knowledge that aids in menu design by a computer is hard-coded and because of that a computerised menu planner cannot handle the menu design problem for an unanticipated client. To address this problem we developed a menu design tool, MIKAS (menu construction using incremental knowledge acquisition system), an artificial intelligence system that allows the incremental development of a knowledge-base for menu design. We allow an incremental knowledge acquisition process in which the expert is only required to provide hints to the system in the context of actual problem instances during menu design using menus stored in a so-called Case Base. Our system incorporates Case-Based Reasoning (CBR), an Artificial Intelligence (AI) technique developed to mimic human problem solving behaviour. Ripple Down Rules (RDR) are a proven technique for the acquisition of classification knowledge from expert directly while they are using the system, which complement CBR in a very fruitful way. This combination allows the incremental improvement of the menu design system while it is already in routine use. We believe MIKAS allows better dietary practice by leveraging a dietitian's skills and expertise. As such MIKAS has the potential to be helpful for any institution where dietary advice is practised.
The safety and well-being of children while they are at school or day care is a major concern in our society. It is therefore important that the professionals who are entrusted with the care of young people possess the knowledge and skills necessary to provide a safe and caring environment for all children, including those with chronic disorders such as diabetes. Each day 35 children in the United States are diagnosed with diabetes mellitus. To make their school experiences positive, it is imperative that school employees be aware of the potential challenges associated with diabetes and how to meet these challenges successfully. This article discusses the role of the school nurse in forming an interdisciplinary team to work with a child with diabetes. It addresses the school nurse's role in diabetes education of food service personnel in the school. Confidentiality issues are also addressed.
This study examined the effect of the "TrEAT Yourself Well" campaign on diners'menu choices using data from four restaurant chains in California. Within each chain, two locations in the greater San Diego area were selected as experimental sites and either one or two locations outside the greater San Diego area were selected as control sites. Various promotional activities, including in-restaurant promotions, community events, and paid media advertising, were conducted in the experimental region to promote healthy menu entrées. The results show that the campaign was successful in reaching diners and had positive effects on their beliefs and attitudes toward healthy dining. The campaign directly increased the probability of a consumer purchasing a healthy menu item by 3.7% (p = .05). By improving consumer attitudes toward healthy menu items, the campaign indirectly increased purchases of these items by 4.4%.
This study examined changes in sales of low fat/low cholesterol foods targeted in a restaurant menu labeling program. Sales of labeled items were tracked before and after the program was introduced, and a subsample of patrons were surveyed for information on visibility and comprehension of the menu labels. Two of the four restaurants had significant increases in the sales of targeted foods following labeling. Comparisons between patrons dining in restaurants which had an increase in sales (I--increase restaurants) to those dining in restaurants which had no overall shift in sales (NI--no increase restaurants) revealed no differences in patron awareness or comprehension of the menu labels. There were age and gender differences between I and NI restaurants, with I restaurants having proportionally more males, and a younger clientele. Taste was the primary reason given by patrons for their entree choice, regardless of whether or not it was labeled. In all four restaurants women and older patrons were more aware of the program and more responsive to its recommendations. These findings suggest that environmental strategies may be an effective method of encouraging dietary changes in the general population, but patron characteristics such as age and gender may influence receptivity to this type of intervention. Future studies aimed at developing effective point of purchase education programs should evaluate these patron characteristics and include more powerful behavior change strategies.
Process evaluation is an essential element of a multicenter trial in order to explain study outcomes and monitor intervention progress. This paper presents the process evaluation model for the Eat Smart School Nutrition Program, the food service intervention component of the Child and Adolescent Trial for Cardiovascular Health (CATCH), and describes the process evaluation strategies developed to assess this program. The paper details (1) measures of program implementation including training, support visits, and program promotion, (2) food service staff characteristics, and (3) measures of mediating variables including secular trends and school meal participation.
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As part of a multi-purpose study, the monetary value of edible plate waste was estimated in 18 large capacity Ministry of Health (MOH) general hospitals in Saudi Arabia. Direct measurement of the plate waste was carried out over 2-days, in which 6 consecutive regular diets were served to 554 Saudi patients (male 268 and female 286) and their 205 attendants (male 12 and female 193). It was estimated that the average plate waste represented approximately 40% of the meal cost/participant/day, and the estimated annual monetary loss for the 5.625 million regular meals to be served to patients and attendants will be around 35 million Saudi Riyals.
Cookin' Up Health is a culturally targeted and individualized tailored nutrition intervention using a computer-based interactive format. Using a cooking show theme, the program demonstrates step-by-step meal preparation emphasizing healthy selection and portion control. Focus groups were conducted with women in two rural counties in West Virginia to guide the development of the intervention. Women felt more susceptible to heart disease because the changing role of women creates more stress and less time; weight loss was a greater motivator for dietary change than was preventing heart disease; social support is a barrier and facilitator for dietary change; cultural heritage and the way women were raised were major barriers to making health changes as adults; convenience and the cost of eating healthier were major factors when trying to make changes in diet; and women did not feel confident in their ability to maintain dietary changes.